BSIG2015-002678-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
Application Number:
BSIG2015-0026
Property Address:
78359 HIGHWAY 111
APN:
604050059
Application Description:
STEVEN CHAFFEE TH
Property Zoning:
Application Valuation:
$2,000.00
Applicant:
PD GROUP DBA SIGNARAMA
41945 BOARDWALK SUITE L
PALM DESERT, CA 92211
D 44, VOICE (760) 777-7125
FAX (760) 777-7011
COMMUNITY DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 8/31/2015
Owner:
HARSCH INV REALTY
!p Q
AUG 31 2015
CITY OF LA QUINTA
COMMUNITY DEVELOPMENT DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
and my License is in full force and effect.
License Cla : D421C45 License No.: 830/31
17
Date: UP/, ' J Contractor.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Divisio
of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant f,I/a�
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
(_) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
(1 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the -performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's
Lender's Address:
1121 SALMON ST 4TH FL
PORTLAND, OR 92253
Contractor:
PD GROUP DBA SIGNARAMA
41945 BOARDWALK SUITE L
PALM DESERT, CA 92211
(760)776-9907
Llc. No.: 830131
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier: _ Policy Number: _
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the La or Code, I shall forthwith
comply wit those rovisions.
0
Date: N Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO.CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application, the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above-
mentionneproperty for inspection purposes.
Date: ti Signature (Applicant or Agent):
FINANCIAL
DESCRIPTION _ . ACCOUNT
A TION
QTY AMOUNT
PAID
PAID DATE'
BSAS SB1473 FEE 101-0000-20306
0 $1.00
$0.00
.PAID BY METHOD
RECEIPT #...,
CHECK #
CLTD BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
PAID BY-:
METHOD
RECEIPT #
CHECK #
CLTD BY.
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forELECTRICAL: $48.34 $0.00
DESCRIPTION
ACCOUNT
QTY.
:AMOUNT
PAID
PAID DATE.
WALL/AWNING SIGN, FIRST
101-0000-42404
0
$24.66
$0.00
PAID BY _
METHOD.
RECEIPT #
CHECK #
CLTD BY
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
,PAID DATE.
WALL/AWNING SIGN, FIRST PC
101-0000-42600
0
$87.02
$0.00
PAID BY
METHOD
RECEIPT #
CHECK #
CLTD BY
Total Paid forSIGN: $111.68 $0.00
TOTALS:00
Description: STEVEN CHAFFEE THE BOOT RACK
CONDITIONS
Type: SIGN
Subtype: Status: APPROVED
Applied: 8/31/2015 PJU
Approved: 8/31/2015 PJU
Parcel No: 604050059 Site Address: 78359 HIGHWAY 111LA QUINTA,CA 92253
Subdivision: PM 19028
Block: Lot: 3
Issued:
Lot Sq Ft: 0
Building Sq Ft: 0 Zoning:
Finaled:
Valuation: $2,000.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
Details: ONE ELECTRICAL ILLUMINATED SIG PER 2013 CBC SA2015-0040
CHRONOLOGY
CONDITIONS
NAME TYPE
NAME
ADDRESSI
CONTACTS
CITY
STATE
ZIP
PHONE
FAX EMAIL
APPLICANT
PD GROUP DBA SIGNARAMA
41945 BOARDWALK
PALM DESERT
CA
92211
SUITE L
CONTRACTOR
PD GROUP DBA SIGNARAMA
41945 BOARDWALK
PALM DESERT
CA
92211
SUITE L
OWNER
HARSCH INV REALTY
1121 SALMON ST 4TH
PORTLAND
OR
92253
FL
FINANCIAL INFORMATION
Printed: Monday, August 31, 2015 12:30:25 PM 1 of 2
SYSTEMS
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETEDRESULT
DATE DATE
REMARKS NOTES
FINAL" BLD.
CLTD
DESCRIPTION
ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
RECEIPT #
CHECK #
METHOD
PAID BY
BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBUILDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
DEVICES, FIRST 20
101-0000-42403
0
$24.17
$0.00
DEVICES, FIRST 20 PC
101-0000-42600
0
$24.17
$0.00
Total Paid forELECTRICAL: $48.34 $0.00
WALL/AWNING SIGN,
101-0000-42404
0
$24.66
$0.00
FIRST
WALL/AWNING SIGN,
101-0000-42600
0
$87.02
$0.00
FIRST PC
Total Paid forSIGN: $111.68 $0.00
TOTALS:00
INSPECTIONS
SEQID INSPECTION TYPE INSPECTOR SCHEDULED COMPLETEDRESULT
DATE DATE
REMARKS NOTES
FINAL" BLD.
PARENT PROJECTS
Printed: Monday, August 31, 2015 12:30:25 PM 2 of 2 CR
SYSTEMS